Scholz, Karl Heinrich and Maier, Sebastian K. G. and Maier, Lars S. and Lengenfelder, Bjoern and Jacobshagen, Claudius and Jung, Jens and Fleischmann, Claus and Werner, Gerald S. and Olbrich, Hans G. and Ott, Rainer and Mudra, Harald and Seidl, Karlheinz and Schulze, P. Christian and Weiss, Christian and Haimerl, Josef and Friede, Tim and Meyer, Thomas (2018) Impact of treatment delay on mortality in ST-segment elevationmyocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial. EUROPEAN HEART JOURNAL, 39 (13). pp. 1065-1074. ISSN 0195-668X, 1522-9645
Full text not available from this repository. (Request a copy)Abstract
Aims The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Methods and results Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n=12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI). Patients were stratified by cardiogenic shock (CS) and out-of-hospital cardiac arrest (OHCA). For patients treated within 60 to 180min from the first medical contact, we found a nearly linear relationship between contact-to-balloon times and mortality in all four STEMI groups. In CS patients with no OHCA, every 10-min treatment delay resulted in 3.31 additional deaths in 100 PCI-treated patients. This treatment delay-related increase in mortality was significantly higher as compared to the two groups of OHCA patients with shock (2.09) and without shock (1.34), as well as to haemodynamically stable patients (0.34, P<0.0001). Conclusions In patients with CS, the time elapsing from the first medical contact to primary PCI is a strong predictor of an adverse outcome. This patient group benefitted most from immediate PCI treatment, hence special efforts to shorten contact-to-balloon time should be applied in particular to these high-risk STEMI patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ELEVATION MYOCARDIAL-INFARCTION; PERCUTANEOUS CORONARY INTERVENTION; TO-BALLOON TIME; FORMALIZED DATA FEEDBACK; CARDIOGENIC-SHOCK; 12-LEAD ELECTROCARDIOGRAM; EARLY REVASCULARIZATION; SYSTEM DELAY; TASK-FORCE; REPERFUSION; ST-segment elevation myocardial infarction (STEMI); Percutaneous coronary intervention (PCI); Cardiogenic shock; Out-of-hospital cardiac arrest; Contact-to-balloon time; Mortality |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 11 Mar 2020 08:16 |
| Last Modified: | 11 Mar 2020 08:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14830 |
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